Information for Prospective Patients
Patient Registration - To Fill Out
Please fill out this form with your desired contact information to allow us to better care for you. After completion, you may print it out and bring it with you to the appointment, or you may save it and email an attachment back to us at [email protected] or [email protected]
If it is filled out in advance, your appointment should move along more quickly.
Financial Policy
Our Financial Policy which we ask you to sign to verify that you have read it and understand the policy.
Please print, fill out, scan, and email back [email protected] or [email protected], or just bring to the appointment. We will soon make this form fillable as well.
If it is filled out in advance, your appointment should move along more quickly.
Referring Physician Form
Our referring physician form. We like to know who sent you to us. If you allow, we send notes to all your physicians so that everyone understands the diagnosis.
You may also have a copy of our clinic notes by regular mail, or email if you desire. Dr. Thomas can provide you with video copies of your vocal cord examination. Just ask.
We also ask you to make note of any other person you would allow us to talk to about your care, even a family member. Otherwise, we would only talk with you.
Please send the completed form to [email protected] or [email protected], or just bring to the appointment.
If it is filled out in advance, your appointment should move along more quickly.
Registration documents
Voice History - fillable
Our voice history form tells us about your troubles including details that assist us in your care.
Please download and fill in the blanks. It is form-fillable in Adobe or Preview. You may print it out and bring it with you to the appointment, or you may save it and email an attachment back to us at [email protected] or [email protected]
If it is filled out in advance, your appointment should move along more quickly.
Notice of Privacy Practices
The following is our Notice of Privacy Practices pamplet - HIPAA.
Directions to and from our Office with Maps
We are located in Portland, Oregon. Check out the Google map or click the .pdf link to launch the document, which also contains directions.